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Dr. Sisti is a pediatrician at St. Louis Children's Hospital, Instructor of Pediatrics at Washington University School of Medicine. Kelsey and her husband are raising two young children and assorted pets.... View More

Obesity Prevention: AAP Policy Explained

The obesity epidemic has increased dramatically in children. Did you know one in five kindergarteners today is already carrying excess weight?

In an effort to start obesity prevention conversations earlier, the American Academy of Pediatrics (AAP) released the new clinical report, “The Role of the Pediatrician in Primary Prevention of Obesity.” It includes some practical ways families can incorporate healthy habits into their busy lives and nip some of these bad habits in bud early on (when they are easier to break).

Practical Tips for Families

Food

It is sometimes a little daunting get our children to be healthy when we ourselves struggle with this task, however, studies have shown that the food we feed our children in infancy and as children have a lasting effect on their health as adults.

Make healthy food easily accessible. Water pitchers, fruits, vegetables, and other low-calorie snacks should be readily available at all times and placed in plain sight; for example, in front of the refrigerator or in large bowls on the kitchen counter or table. Replace the cookie jar with a fruit bowl.

Watch portion sizes. They have increased dramatically over the past few years. Use a smaller sized serving spoon and smaller plates to help children take appropriate servings of higher calorie foods. When you go out to eat as a family, recognize the portion sizes and discuss eating half and taking the other half home to enjoy later.

Eat breakfast. Skipping meals, especially breakfast, has been associated with obesity. Since mornings can be time-constrained, look for healthy, on-the-go breakfast options.

Cook with your kids. Children take pride in being helpers, so let them mix the bowl or add ingredients to what you are making, and they’ll be more likely to eat what they helped create.

Count the colors. The more colors on their plate, the healthier, so make it a game or competition and have them count how many colors are on their plates. (e.g., two green vegetables, one orange, one yellow…)

Give your children the chance to make some decisions, when applicable, on what they will be eating for dinner. (e.g., Would you like green beans or peas for dinner tonight?)

Limit treats and snacks. Children should have three well-balanced meals and one to two small snacks over the course of the day. Do not let your children graze all day; they need structure to help limit the snacking. Treats are just that, treats on special occasions like birthdays and holidays. They should not be a daily part of your child’s diet.

Limit the juice to 4 ounces or less a day and avoid sugar-sweetened drinks like soda and energy drinks.

Avoid using food as a reward (i.e., celebrating with ice cream, going out to eat) or a punishment (restricting food for bad behavior).

Don’t eat directly from the package. High-calorie snacks should be repackaged at home in smaller bags or containers.

Place pre-cut vegetable sticks or fruit in bowls on the lower shelves in the front of the refrigerator.

For older children, freeze blueberries or grapes on a cookie sheet, then place in a plastic bag or container. This is a refreshing treat that is also healthy for them.

Sleep

Children who do not get enough sleep are at an increased risk of obesity. Parents can encourage good sleeping habits by forming a nighttime routine with small children. Avoid putting small children to bed with bottles or cups, and remove TVs from bedrooms to encourage good sleep hygiene.

Screen time

The AAP recommends limiting screen time to two hours or less per day. This may be challenging for parents to implement, because children increasingly do more than one thing at a time (homework and texting) and because the limits between entertainment and education are often blurred, especially when using a computer.

Physical Activity

Busy lives make finding time to exercise difficult. But, physical activity does not necessarily mean sports — family activities and active play (family walks and hikes, bicycle trips, outdoor games and activities) all count!

If you don’t have a large yard, find the parks or playgrounds near your home and plan to go as a family. Involve you children in the planning and they will remind you that tonight is kickball or bike riding. Many cities have community centers, like the YMCA, that have activities for children of all ages. Aim for 60 minutes of physical activity each day.

College students

Some young adults who have been involved in athletic activities in high school often drop these activities when entering college or the workforce, without a corresponding decrease in the amount and types of food they eat. Food availability and eating habits on college campuses are notoriously bad, and alcohol intake contributes to an increase in “empty calories.” Parents should talk to their child about a plan to remain active and eat healthy while away at school.

Encouraging Your Child

Your children take their cues from you, so being healthier needs to be a family goal. In small steps and in a nonjudgmental way, parents can encourage behavior changes. Giving your child positive feedback, such as pointing out and praising positive behaviors while ignoring or positively addressing behaviors that should be changed, is critical for success.

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